Trump and Veterans

Trump and Veterans

Donald Trump has signed and implemented several measures to improve the help available to veterans. As with everything in Washington these days, there is significant disagreement as to their efficacy, but we can still discern several noticeable bills and actions, and assess their impact.

Private Health Care?

The biggest development is extending access to private health care. In June of 2017, President Trump extended the Choice Act. This gave veterans the option of going to private providers for their health care needs after they waited 30 days or have to drive 40 miles or more to the nearest VA hospital. This has been downplayed by some analysts because it was an existing program. But I remember reading the news about this bill, and it was controversial enough that its passage wasn’t assured. Trump deserves credit for signing an extension of a good bill that was attacked as “privatizing” the medial system. Of course, privatization isn’t a bad thing. In fact, considering the lack of speedy care and the numerous flaws encountered in the system, private medical vouchers aren’t such a bad idea.

Trump has addressed another one of these problems after a scandal in the Obama administration showed that some VAs doctored their records in order to artificially reduce wait times. In 2014 it was found that the Phoenix VA had such long wait times that veterans died waiting for care. This often happens when a turgid state-run bureaucracy meets efforts to reform the system. Trump’s measures provide accountability for misbehaving executives, protections for whistleblowers, and a way to recover ill-gotten bonuses. This doesn’t produce the same incentives as a private system that would increase performance while decreasing cost, but it is a step a forward.

Even then, some argue Trump is accused of not really doing anything special. According to those critics, this bill included measures that have been discussed for the last 40 years. But one of the appeals of Trump is that he cuts through red tape. For example, presidents for over 20 years have discussed moving the American embassy to Jerusalem, but Trump is the only one to actually do it. It’s true that reforms have been discussed before, but Trump should receive credit for implementing them and these are necessary changes for the VA.

Trump has also updated the VA’s use of medical records. He signed reformed legislation that will “ultimately result in all patient data residing in one common system and enable seamless care between the departments without the manual and electronic exchange and reconciliation of data between two separate systems” the former VA chief, David Shulkin, said. Like the previous measures, this is only a small step as this is still a government-run bureaucracy with a host of problems. But every small step is still helpful for Vets.

Now

More recently Trump’s record continues to be rather mixed. First, he signed the VA Mission Act that expands the veteran’s access to private insurance. This builds upon the previous programs like the Choice Act, though the details of the program are still to be determined by the new VA Secretary Robert Wilkie. On top of that, it provides incentives to hire more doctors and health care providers and sets up a commission on which facilities to modernize or close.

The veterans that appeared at the signing ceremony called this perfect and a step up from the nearly 4 hour round trip drives they previously had to do. In signing the bill Donald Trump said that freedom and choice are beautiful things. While this is a bit of Trump’s typical puffing, it shows he is on the right track in that freedom and choice are certainly the best ways to receive the best coverage at the best cost.

The other item made just as good of a news conference but is far less substantive. Donald Trump said that he has set up an executive task force to study the matter of veteran suicide. This is largely a photo op to appear like he is helping veterans and follows the standard practice of many politicians. The playbook is to hold a news conference where the politician appears very concerned about a problem and as though he is doing something about it. A commission by executive order is the safest choice that requires the least amount of effort. The commission will study how to prioritize related research, encourage collaboration with the private sector and develop a proposal to offer grants to state and local governments to support efforts to prevent veteran suicide. Yet mostly this is a way for politicians to look like they are helping and gain political credit for it, without actually staking political capital on it.

If we take the suicide numbers of veterans at face value, while Trump’s commission leisurely takes their time in coming to a solution hundreds will continue to die. Something truly bold and more helpful would have been to write a bill and have a stalwart Republican introduce it in the House, and then work with congressional allies, and build bridges across the aisle, to have something substantive passed.

Even then, in most cases, the government solution to a problem is to create a program and throw money at it. For example, “encouraging collaboration” and offering grants to state and local governments is a fancy way of saying exactly that. This produces great headlines but in reality, it means they fund rather disorganized and bordering on incompetent programs. As veterans who survived spending time in the often dysfunctional military, and then navigate the turgid VA health care system with often serious health complications, I’m not sure offering a commission to study additional programs really excites them. But the program has a chance at helping people and is still another small step forward.

Big Picture

So far there have been a series of small steps that show incremental improvement. There is something far greater at play here. Supporting the veterans is often a trendy virtue signaling exercise for politicians. A far smaller percentage of American men and women actively serve than ever before in American history. This removal of most average and everyday Americans from the life of the military, yet their recognition of the importance of the military create what I call uncritical hero worship. Thanking the veterans and showing support becomes an exercise in what seems like empty praise.

For politicians, it becomes even more heightened as they seek to curry the most favor with the most amounts of voters for the least amount of effort. They also have to show they care about veterans because they vote for the wars and operations that put the soldiers in harms danger, and they vote for the budget that determines their equipment. Thus, the politicians end up “waving the bloody flag” at each other and for the public.

But very few take a moment to stop and consider what actually the best way to support the military is. It isn’t saying the words or getting mad at people online if they don’t celebrate Memorial Day the way you think they should. (In fact, the whole point of being free, is having the liberty to forget the sacrifices that made you free.) For every American, supporting the military and our veterans should consist of an individual having a carefully reasoned idea of what American’s foreign policy should be, what role the military has in that policy, and then thoughtfully voting and advocating for the politicians that most closely match that policy.

The final step is to hold those politicians feet to the fire and make sure they follow through. That is why, for example, Trump’s withdraw from Syria is rather important. He ran against the mess in the Middle East and correctly sensed that many Americans are sick of never-ending wars. He intervened long enough to defeat the territorial control of ISIS, then announced the withdraw of American soldiers. Having fewer soldiers in harm’s way and the combat zone for less time means that there will be fewer soldiers with physic and physical trauma. This in turns means that America will have less need for massive VA programs and suicide prevention task forces.

Conclusion

It is vitally important to help and support the American soldier. Trump’s record on the VA is somewhat mixed. He has signed legislation that helps to privatize the system and provide incentives to hire more doctors. He also signed legislation that holds the VA more accountable for abuses. Both of these are somewhat limited and imperfect. They also build upon previous efforts, though Trump still deserves credit for them. Trump has also signed an executive order creating a task force to study the situation. This is mostly a cheap win that doesn’t offer substantive and brave changes. But it’s important to remember the best way to support the military is to understand the root cause of why so many veterans need medical and mental health support after their military service, and Trump should receive credit for trying to limit America’s involvement against ISIS by withdrawing from Syria.